Cochrane for Clinicians

Putting Evidence into Practice

Electronic Cigarettes for Smoking Cessation


Am Fam Physician. 2016 Feb 1;93(3):178-179.

Clinical Question

Are electronic cigarettes safe and effective in helping smokers to quit or reduce their smoking?

Evidence-Based Answer

Electronic cigarettes with nicotine increase smoking cessation rates compared with placebo, with effectiveness similar to that of nicotine patches. In addition, more patients using electronic cigarettes with nicotine were able to halve their use of cigarettes than those using placebo electronic cigarettes or nicotine patches. Long-term safety is unknown. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Electronic cigarettes have steadily increased in popularity as an alternative to conventional tobacco cigarettes, and 21% of American smokers report having tried them.1 Although their long-term safety and health effects are not known, the most common reason given for using electronic cigarettes has been to quit or reduce cigarette smoking.2,3 Although not marketed as smoking cessation devices and therefore not regulated by the U.S. Food and Drug Administration, electronic cigarettes are widely used for this purpose.1

This Cochrane review combined data from two randomized


McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;(12):CD010216.


show all references

1. Ebbert JO, Agunwamba AA, Rutten LJ. Counseling patients on the use of electronic cigarettes. Mayo Clin Proc. 2015;90(1):128–134....

2. Grana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014;129(19):1972–1986.

3. Rutten LJ, Blake KD, Agunwamba AA, et al. Use of e-cigarettes among current smokers: associations among reasons for use, quit intentions, and current tobacco use. Nicotine Tob Res. 2015;17(10):1228–1234.

4. U.S. Preventive Services Task Force. Final recommendation statement: Tobacco smoking cessation in adults and pregnant women: behavioral and pharmacotherapy interventions. September 2015. Accessed December 3, 2015.

5. Bhatnagar A, Whitsel LP, Ribisi KM, et al.; American Heart Association Advocacy Coordinating Committee, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Electronic cigarettes: a policy statement from the American Heart Association. Circulation. 2014;130(16):1418–1436.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at


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